Generally in radiation therapy the aim is to irradiate a target within the human body in order to combat diseases, in particular cancer. For this purpose a high dose of radiation is specifically generated in an irradiation center (isocenter) of an irradiation apparatus. During irradiation the problem often arises that the irradiation target in the body can move. For instance, a tumor in the abdomen can move during breathing. On the other hand, in the period between radiation treatment planning and actual radiation treatment a tumor may have grown or have already shrunk. It was therefore proposed to check the position of the irradiation target in the body during radiation treatment by imaging, in order to control the beam or if necessary discontinue the irradiation, and thus increase the success of the therapy. This is in particular relevant for irradiation targets in the upper and lower abdomen as well as in the pelvic area, for example the prostate. To minimize the dose of radiation outside the target volume and thus protect healthy tissue, the entire radiation generation is moved around the patient. This concentrates the radiation dose in the beam in the area of the rotational axis.
Both X-ray and ultrasound systems were proposed as the imaging medium for monitoring the therapy. These, however, provide only a limited solution to the problem. In the case of ultrasound imaging the necessary penetration depth is lacking for many applications. In X-ray imaging the X-ray sensors can be disrupted or damaged by the gamma radiation of the accelerator. Furthermore, the quality of the tissue images is often unsatisfactory.
For this reason, at present mainly positioning aids and fixing devices or markings made on the skin of the patient are used to ensure that the patient is in the same position in the irradiation apparatus as decided in the radiation treatment planning and that the irradiation center of the irradiation apparatus is actually consistent with the irradiation target. These positioning aids and fixing devices are, however, expensive and in most cases they are also uncomfortable for the patient. In addition, they conceal the risk of irradiation errors because as a rule no further check of the actual position of the irradiation center is carried out during irradiation.
Magnetic resonance is a known technique which permits both particularly good soft-tissue imaging as well as spectroscopic analysis of the area being examined. As a result this technique is fundamentally suitable for monitoring radiation therapy.
In U.S. Pat. No. 6,366,798 a radiation therapy device is combined with various magnetic resonance imaging systems. In all the different versions mentioned here the magnet arrangement of the magnetic resonance imaging system is divided into two parts. In addition, in some versions key parts of the magnetic resonance imaging system rotate with the radiation source of the radiation therapy device. In each case the radiation source is outside the magnetic resonance imaging system and must be protected by means of shields from the stray field of the magnetic resonance imaging system. A division of the magnet, a rotatable magnet and shielding of the radiation source represent elaborate technical solutions and increase the cost.
In GB 2 427 479 A, U.S. Pat. No. 6,925,319 B2, GB 2 247 478 A, US 2005/0197564 A1 and US 2006/0273795 A1 further devices are described in which a radiation therapy device or an X-ray imaging system are combined with a magnetic resonance imaging system.
GB 2 393 373 A describes a linear accelerator with an integrated magnetic resonance imaging system. In one exemplary embodiment the magnetic resonance imaging system comprises means for compensation of a magnetic field in order to minimize the field strength of the magnetic field of the magnetic resonance imaging system at the location of the accelerator. In another exemplary embodiment a filter is used in order to compensate for possible heterogeneity caused in a therapy beam by the magnetic field of the magnetic resonance imaging system.